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Possibilities of correction of elevated lipoprotein (a) levels

Authors: Yaroustovsky M.B.1, Abramyan M.V.1, Rogal'skaya E.A.1, Komardina E.V.1, Nazarova E.I.1, Grigoryan D.A.2, Podschekoldina O.O.1

Company: 1 Bakoulev National Medical Research Center for Cardiovascular Surgery of Ministry of Health of the Russian Federation, Rublevskoe shosse, 135, Moscow, 121552, Russian Federation;
2 Pirogov Russian National Research Medical University of Ministry of Health of the Russian Federation, ulitsa Ostrovityanova, 1, Moscow, 117997, Russian Federation

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Type:  Reviews


DOI: https://doi.org/10.24022/1997-3187-2019-13-2-129-146

For citation: Yaroustovsky M.B., Abramyan M.V., Rogal'skaya E.A., Komardina E.V., Nazarova E.I., Grigoryan D.A., Podschekoldina O.O. Possibilities of correction of elevated lipoprotein (a) levels. Creative Cardiology. 2019; 13 (2): 129–46 (in Russ.). DOI: 10.24022/1997-3187-2019-13-2-129-146

Received / Accepted:  31.05.2019/05.06.2019

Keywords: atherosclerosis, cholesterol, low density lipoprotein cholesterol, lipoprotein(a), lipoprotein apheresis, H.E.L.P.-apheresis, cascade filtration cascade lipidfiltration, cardiovascular diseases, coronary heart disease

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Abstract

High blood lipoprotein (a) (Lp(a)) could promote atherosclerosis development directly as well as indirectly. Today, blood purification methods remain the most reasonable for reducing hyperlipoproteidemia. This method plays role for primary and/or secondary prevention of complications of the cardiovascular system. Selective lipoprotein apheresis techniques can reduce the level of Lp(a) by 65–75% per procedure. At the same time, these methods are aimed at correcting high levels of total cholesterol, low-density lipoprotein cholesterol, triglycerides, and fibrinogen. Regular treatment with lipoprotein apheresis can improve the prognosis of the cardiovascular disease, the effectiveness of surgical and medical treatment, and, most importantly, improve the quality of life of patients. In this report, we present the clinical cases of the use of selective lipid apheresis – H.E.L.P-therapy (Heparin-induced Extracorporeal Lipoprotein Precipitation) and cascade lipidfiltration – in patients with type IIa hypercholesterolemia in combination with hyperlipoproteidemia. To date, hyperlipoproteidemia (more than 50 mg/dL) along with progressive cardiovascular disease has been approved as indication for regular lipoprotein apheresis. Apheresis techniques are the most correct in the treatment of elevated levels of Lp(a), but in each case an individual approach is required to determine the protocol of the procedure.

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About Authors

  • Mikhail B. Yaroustovsky, Professor, Corresponding Member of Russian Academy of Sciences, Deputy Director, Head of Department, ORCID
  • Marina V. Abramyan, Cand. Med. Sc., Leading Researcher, ORCID
  • Ekaterina A. Rogal’skaya, Cand. Med. Sc., Doctor of Clinical Laboratory Diagnostics, ORCID
  • Ekaterina V. Komardina, Junior Researcher, ORCID
  • Elena I. Nazarova, Transfusiologist, ORCID
  • David A. Grigoryan, Student, ORCID
  • Ol’ga O. Podshchekoldina, Doctor of Clinical Laboratory Diagnostics, ORCID

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


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